title: Combined lectin/monoclonal antibody purging of bone marrow for use in conjunction with autologous bone marrow transplantation in the treatment of multiple myeloma.
abstract: What was thought at the time to be a real breakthrough in myeloma therapy came in 1983 when McElwain reported that complete remission could be gained by means of a single, very high, dose of melphalan (HDM). Between 20 and 30% of patients attain complete remission with HDM (1). These observations led directly to exploration of the role of autologous bone marrow rescue following high-dose therapy, since the morbidity and mortality associated with prolonged bone marrow aplasia caused by these doses are unacceptably high (2) Most patients with myeloma are relatively old for allogeneic bone marrow transplantation, since graft-vs-host reactions tend to be poorly tolerated in people over 40. Autologous transplantation, however, carries the obvious disadvantage of potential reinfusion of malignant cells. Efforts have therefore been made to develop systems for in vitro purging to remove potentially malignant cells prior to reinfusion of the marrow (3,4). Although the nature of the initial malignant cell in myeloma is unknown, it is assumed that purging should entail at least the removal of plasma cells and B-lymphocytes.
authors.affiliation: Department of Haematology, Countess of Chester Hospital, Chester, UK.
authors.forename: E G
authors.initials: EG
authors.lastname: Rhodes